Kocher入路联合前内侧切口内固定手术治疗肘关节恐怖三联征  

Kocher Approach Combined With Anteromedial Incision Internal Fixation for the Treatment of Elbow Horror Triad

作　　者：宋俊杰 王铁锤 郭星 SONG Junjie;WANG Tiechui;GUO Xing(Department of Orthopedics,Jincheng University Hospital,Jincheng Shanxi 048006,China)

机构地区：[1]晋城大医院骨科,山西晋城048006

出　　处：《中国卫生标准管理》2022年第6期65-68,共4页China Health Standard Management

摘　　要：目的探究Kocher入路联合前内侧切口内固定手术治疗肘关节恐怖三联征的临床效果。方法选择晋城大医院2016年1月—2019年12月收治的肘关节恐怖三联征60例,采用随机抽签法分为对照组(30例,Kocher入路)与联合组(30例,Kocher入路+前内侧切口内固定手术),记录两组患者手术时间、术中出血量,随访获得术后肘关节活动度(伸肘角度、屈肘角度、屈伸范围及前臂旋转范围)、切口愈合、骨折愈合、术后并发症情况,采用Mayo肘关节功能评分(Mayo elbow performance score,MEPS)评价术后肘关节功能。结果60例患者均获得有效随访,随访时间3~38个月,平均(18.40±3.17)个月。联合组手术时间长于常规组,差异有统计学意义(P<0.05),两组术中出血量差异无统计学意义(P>0.05);术后联合组伸肘角度、屈肘角度、屈伸范围及前臂旋转范围均大于对照组,差异有统计学意义(P<0.05);两组患者切口均为一期愈合,骨折获得临床愈合,未发生切口感染、骨折延迟愈合、骨折不愈合、桡骨头坏死等并发症,内固定稳定性良好。末次随访联合组MEPS评分高于对照组,差异有统计学意义(P<0.05)。结论Kocher入路联合前内侧切口内固定手术治疗肘关节恐怖三联征可获得满意术野,便于修复损伤骨与韧带组织,便于术后重建肘关节功能,预后良好,值得应用与推广。Objective To explore the clinical effect of Kocher approach combined with anterior medial incision internal fixation in the treatment of the elbow horror triad.Methods A total of 60 cases of elbow horror triad who were admitted to Jincheng University Hospital from January 2016 to December 2019 were selected and divided into control group(30 cases,Kocher approach)and combined group(30 cases,Kocher approach+anterior medial incision internal fixation)by random drawed,the operation time and intraoperative blood loss of the two groups of patients were recorded.Obtained the postoperative elbow range of motion(elbow extension angle,elbow angle,range of flexion and extension,and forearm rotation range),incision healing,fracture healing,postoperative complications,and Mayo elbow performance score(MEPS)to evaluate postoperative elbow joint function.Results All 60 patients were followed up effectively.The follow-up time was 3to 38 months,with an average of(18.40±3.17)months.The operation time of the combined group was longer than that of the conventional group,and the difference was statistically significant(P<0.05).There was no significant difference in the amount of intraoperative blood loss between the two groups(P>0.05).The postoperative elbow extension angle,elbow flexion angle,flexion and extension range and forearm rotation range of the combined group were greater than the control group,the difference was statistically significant(P<0.05).The incisions of the two groups were healed at first stage,and the fractures were healed clinically There were no complications such as wound infection,delayed fracture union,nonunion of fracture,and necrosis of the radial head.The internal fixation was stable.The MEPS score of the combined group at the last follow-up was higher than control group,and the difference was statistically significant(P<0.05).Conclusion The Kocher approach combined with anteromedial incision internal fixation can obtain satisfactory surgical field for the treatment of elbow horror triad,which is convenie

关 键 词：Kocher入路 前内侧切口入路 内固定 肘关节恐怖三联征 并发症 Mayo肘关节功能评分 

分 类 号：R683[医药卫生—骨科学]